Is personal experience necessary for successful addiction treatment?

In the “recovery” community, one often hears about how the best person to reach an addict is another addict in recovery. The question is whether personal experience with, and victory over, addiction is necessary for a counselor or therapist to be successful in providing successful addiction treatment?

I’ll spoil the surprise by telling you that I personally don’t believe such personal experience is necessary, and that is despite my own personal experience with addiction. I also think that spreading the notion that the above is true is counterproductive to addiction treatment as a field and that it creates an atmosphere whereby mental health professional are a little weary of getting involved in treating drug addicts.

Personal experience as a requirement for treatment in general?

Imagine for a second that you had acne and needed to get a treatment for it, would you only seek out dermatologists who have had severe acne as teenagers themselves thinking they will be best able to assist you? What about if you were diagnosed with cancer or diabetes? I’m assuming most of you can see that requiring the ones treating us to have experience with the same issues we’re dealing with is a bit silly, at least in the physical health sense. We need clinicians that know what they’re doing, can diagnose problems quickly and accurately, and who are familiar with appropriate treatment options and keep up with the latest advancements. They don’t need to have personal-experience with the problem.

But what about mental health issues like depression, schizophrenia, or bipolar disorder, would having one of those require a therapist who suffers from the same disorder in order to truly provide tangible results? Should schizophrenics only be treated by schizophrenics? Here again I think that most people can see that experience is not necessary. It might be nice to have a therapist who sympathizes, but really, what we need is knowledge and ability, which often involved empathy, but not necessarily shared experience.

So what makes addiction so different and special?

There’s no doubt that addicts like to think of themselves as special. I would certainly place myself in that group and have personally heard countless addicts who are no longer using exclaim that once addict recover “we are a special and capable bunch.” All of this makes sense in the whole “in-group/out-group” mentality that is so familiar to everyone in psychology as an effect generally observable in the population. But my sense is that when it comes to treatment it can be a dangerous premise.

Think about it – There is no question that addicts are far less common than the general non-addicted population. This means that in essence, believing this dogma – that addicts are best treated by other addicts – leaves the field less open to outside influence that are no doubt able generate great insight into the addiction treatment field. We can feel as special as we want, but I hope that no one believes that addicts somehow have a monopoly on knowledge, expertise, ability, and empathy. We don’t, and thinking we do is at best narcissistic and at worst ignorant and stupid.

I work with dozens of researchers who have no first-hand knowledge of what smoking crack uncontrollably is like (and probably a handful who do) and I can tell you that each of them has had incredible insight into the problems of addiction. I can also tell you that I’ve met many addicts in recovery who think they have found the end-all-be-all answer to our collective problems simply because these things have worked for them. Experience as an addict does not equal insight into addiction treatment. Experience in recovery may give some insight, but thinking that it is necessary and sufficient for providing great treatment is… unwise.

I believe that we need to get better at measuring, identifying, and replicating good addiction treatment, not setting up barriers for clinicians interested in treating addicts based on their own personal experience. My guess is that as we do this we’ll find that some addicts are great at treating addiction and some are horrible and that the same goes for “normies.”

4 responses to “Is personal experience necessary for successful addiction treatment?”

  1. Hi,
    I totally agree, I think that as a former addict it feeds into the special and different mythology that we take refuge in to receive treatment from a former addict. In reality it makes no difference whatsoever and the quality and effectiveness of a therapeutic relationship has to do with the innate humanity and training of a professional,nothing else, both of which are hard to evaluate until realtime work begins.
    The other critical component of a successful treatment experience is the client themselves, without courage and willingness – however presented – there isnt a lot to work with for anyone.
    We arent so special or different anyway, its all human stuff.
    Thank you, Barry

  2. Personal experience might help treating certain addicts. For example, it might help establish the credibility and sense of empathy on a level some addicts need in order to take the next step in recovery therapy. In other words, the addiction therapist having personally experienced and survived and recovered from the addiction’s journey to hell and back may be a necessary component for the addict in treatment to allow an empathic-helping relationship to be formed, . Also, being a former addict would help in perceiving all the lies and BS addicts pull….if you’re not a former addict you’d likely miss a lot of this addiction-driven sociopathy.

  3. Actually the clinical treatment industry has only accepted aspects of the recovery movement, since the early “90’s. It has fought much of the movement, and it has had some heart breaking developments of its own accord over the decades before. Unfortunately, many state boards and agencies inhibit individuals with first hand experience to work within the industry of treatment, and it is their life experiences which inspired them to make a difference in peoples’ lives. I believe only by the use of mutual understanding of the benefits of all concerns can flaws, such as “revolving door”, pushed through the system, and financial benefit surpassing success can individuals acquire the best care and outcome to treatment, the return of productive lives.

    • David, I don’t know a single state-board that inhibits individuals with an addiction past from working within the industry. Can you name some? Also, with more than 60% of treatment centers citing 12-step-facilitation as their main approach, what exactly do you mean when you say the industry has only accepted aspects?

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